Individual
DR. GREGORY M THACKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
506 MADISON AVE N, DOUGLAS, GA 31533-4616
(912) 384-7200
(912) 384-0885
Mailing address
506 MADISON AVE N, DOUGLAS, GA 31533-4616
(912) 384-7200
(888) 977-3076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9888
GA
Other
Enumeration date
07/17/2006
Last updated
03/02/2016
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